When Your Child Has a Brain Abscess

A brain abscess is an infection in the brain caused by bacteria or fungus. In response to the infection, the body forms a sac around the affected area. A brain abscess can press on the brain, damage tissue, or block blood vessels in the brain. It's a serious and life-threatening condition that must be treated right away. With treatment, some children can recover with few or no complications. Recovery can vary.

A brain abscess can damage brain tissue or block vessels in the brain and must be treated right away.

What are the causes of a brain abscess?

Your child may have developed a brain abscess in one of the following ways:

• Bacteria or fungus may have traveled through the bloodstream to the brain from another area of infection in the body.

• Bacteria or fungus may have entered the brain directly through a wound such as a head injury or surgery.

What are the symptoms of a brain abscess?

Symptoms for a brain abscess can come on slowly or suddenly. They can include:

• Fever

• Headache

• Stiff neck

• Nausea or vomiting

• Seizures or convulsions

• Trouble with vision and sensitivity to light.

• Trouble with speech, balance, or movement

• Problems staying awake and alert

How is a brain abscess diagnosed?

Many times, a brain abscess causes severe and sudden symptoms that should be seen in an emergency room. Your child will likely see a pediatric neurologist or a neurosurgeon for diagnosis and treatment. This is a doctor who specializes in neurologic problems in children. The doctor examines your child. They also ask about your child’s health history and symptoms. Your child may also need to see a specialist in infectious disease. The following may then be done:

• Neurologic exam to check how well your child’s nervous system is working. During the exam, the doctor checks your child’s muscle strength, balance, coordination, and reflexes. They may also check skills such as thinking, memory, vision, hearing, and talking.

• MRI or CT scan to provide detailed pictures of the brain. These help the doctor find the brain abscess and see how large it is. Contrast dye may be used to make the brain abscess easier to see. Medicine can be given to help your child stay calm and lie still during the tests.

• Spinal tap (lumbar puncture) to check the health of the fluid around the brain and spinal cord (cerebrospinal fluid). During the test, the low back is numbed. Then a needle is put into the spinal canal and a sample of the fluid is taken and checked for signs of bacteria or fungus. This test is important to diagnose the exact cause of your child's brain abscess. It also helps the doctor figure out the right treatment for your child.

• Antibiotics to treat a possible infection. This depends on your child's health history and other health problems. The antibiotics will be started to treat the most likely infection before cultures show a specific cause. If doing a spinal tap is dangerous because of location and size of the abscess, your child may need surgery to ease the pressure and also get a sample of the abscess.

How is a brain abscess treated?

• Hospital care is needed right away for a brain abscess. Your child is carefully watched until symptoms improve.

• Treatment consists of medicines given by an IV (intravenous) line. In severe cases, the medicines are given directly into the brain. Medicines can include antibiotics, antifungal medicines, steroids, and medicines to decrease the pressure in your child's brain due to the abscess.

• Your child’s doctor will speak with you about other forms of treatment, such as surgery, if they are needed.

• The overall treatment time will vary for each child. In some cases, treatment can even be completed at home.

What are the long-term concerns?

After treatment, many children recover completely. Some children will have ongoing nervous system problems such as trouble with speech or movement. They may even have seizures. Regular follow-up with the doctor may be recommended depending on your child’s condition. Supportive care, such as speech, physical, or occupational therapy, may be prescribed to help your child recover.